RFI-263-22-000001 USAID Zimbabwe MnCHFP.pdf

REQUEST FOR INFORMATION (RFI)

RFI Number: RFI-613-22-000001 Activity Title: Maternal, Neo-Natal and Child Health & Family Planning

(MnCH/FP) Issuance Date: October 13, 2021 Response Date: November 12, 2021 Response Email Addresses: J. Zeb. Simpson, Contracting/Agreement Officer at jsimpson@usaid.gov

Joyce Machingauta, A & A Specialist at jmachingauta@usaid.gov

Subject: Request for Information (RFI) and Market Research for USAID/Zimbabwe

Maternal, Newborn, Child Health and Family Planning Activity/Activities

To all Interested Respondents/Parties:

The purpose of this Request for Information (RFI) is to collect written information from all interested public and private parties, identifying innovative solutions to address an activity or activities with the preliminary title of “USAID Zimbabwe Maternal, Newborn, Child Health and Family Planning Activity,” in which USAID seeks feedback from potential responsible non-governmental organizations/ entities that can provide, quality maternal, newborn, child health and family planning (MNCH/FP) services in Zimbabwe.

The main result of the activity/activities will be to deliver comprehensive high quality MNCH/FP services through implementing partners/ contractors. The proposed background to the MNCH and FP activity/ activities is attached to this letter.

This is an RFI, not a Request for Application (RFA) or Request for Proposal (RFP) and is not to be construed as a commitment by the U.S. Government to issue any solicitation or ultimately award a grant or a contract on the basis of this RFI, nor to pay for any information submitted as a result of this request, nor does it commit the Government to pay for costs incurred in the preparation and submission of any comments. Do not submit any applications at this time;

only the information requested in this RFI will be reviewed. Responses will be treated as confidential. USAID/Zimbabwe anticipates issuing one or two solicitations in early Fiscal year 2022. Therefore, this RFI is being posted on both sam.beta.gov and grants.gov.

USAID is seeking information from organizations with technical expertise and experience in the areas described in Attachment 1 (Background to Proposed Activity) including in strengthening the national MNCH/FP service delivery capacity and providing technical assistance to the Ministry of Health and Child Care (MOHCC) to improve MNCH/FP health outcomes in Zimbabwe. The information provided will be used to help USAID finalize activity design.

mailto:jsimpson@usaid.gov mailto:jmachingauta@usaid.gov http://sam.beta.gov/ http://grants.gov/

USAID may revise the structure and concept of the activity based on comments received but is not obligated to do so.

Responses to this notice must be received no later than the due date and time stated above in this notice. All information provided will become the property of USAID, will not be returned, and will not be released publicly. USAID reserves the right to use information provided by respondents for USAID’s own purposes. Proprietary information must not be sent.

Submission Instructions Interested parties who consider themselves qualified to address the technical areas described in this RFI are invited to submit a response in the format specified in the attached template. In addition to the questions, USAID is contemplating the use of either an Assistance or an Acquisition instrument in the activity design and is requesting feedback on the questions outlined (ATTACHMENT 2). Please submit your response to the USAID/Zimbabwe Office of Acquisition and Assistance through the response email addresses and no later than the date and time listed above.

The issuance of this request will not restrict the Government’s ultimate approach, if any.

Respondents are advised that USAID is under no obligation to acknowledge receipt of the information, answer any questions or provide feedback to the respondents with respect to any information submitted. Any information submitted in response to this notice is voluntary.

USAID/Zimbabwe is not responsible for any costs incurred in responding to this RFI nor will funding be made available prior to any award. Respondents are responsible for all costs incurred prior to award. Take note that not responding to this request does not preclude participation in any future solicitation, if any is issued.

Thank you for your interest in USAID programs.

Sincerely, J. Zeb Simpson Agreement/Contracting Officer

Attachment 1: Proposed Activity Background Attachment 2: RFI submission Instructions and Response Template

Attachment 3. FAR 52.215-3 “Request for Information or Solicitation for Planning Purposes

(OCT 1997)”

ATTACHMENT 1 – PROPOSED ACTIVITY BACKGROUND

1.1. Maternal Newborn and Child Health Background

The national maternal mortality ratio, at 462 per 100,000 live births (Multiple Indicator Cluster Survey (MICS) 2019), although a significant decline from the 651 per 100,000 live births in 2015, remains unacceptably high and well above the Sustainable Development Goals target of 70 per 100,000 live births. Ninety-three percent of pregnant women seek antenatal care (ANC) while 86 percent of pregnant women deliver in health facilities with skilled birth attendants

(MICS 2019).

Hemorrhage, hypertensive disorders of pregnancy, and infection remain the three leading causes of maternal mortality. The national maternal and perinatal death surveillance and response (MPDSR) audit reports of 2019 indicate that delayed care at health facilities contributes to most deaths. This is due to human resource challenges, inadequate equipment, and infrastructure -especially at tertiary hospitals - and inconsistent commodity availability.

Complications from unsafe abortions are also a major public health concern in Zimbabwe. Life-saving post-abortion care services—for women who experience incomplete spontaneous abortion as well as those who have unsafe abortions—are often not available at primary care facilities, and hence they generally refer women to district and provincial hospitals for life-saving health care.

The under-five mortality ratio declined from 69 deaths per 1,000 live births in 2015 (ZDHS) to 65 deaths per 1,000 live births in 2019 (MICS). The infant mortality ratio has also declined from 50 deaths per 1,000 live births in 2015 (ZDHS) to 47 deaths per 1,000 live births in 2019 (MICS). The neonatal mortality rate (NMR) has increased from 29 to 32 deaths per 1,000 live births between 2014 and 2019, missing the target to reduce NMR to 20 deaths per 1000 live births by 2020. Newborn deaths contribute approximately 40 percent of under-five deaths.

The three major causes of death among newborns in Zimbabwe are complications of prematurity, birth asphyxia, and sepsis. These causes suggest that health providers do not consistently deliver high-impact services such as helping babies breathe (HBB), integrated management of neonatal and childhood illness (IMNCI), and kangaroo mother care. The major causes of post-neonatal mortality in children are pneumonia, HIV/AIDS-related complications, and diarrheal diseases, which may be associated with underlying malnutrition.

The suggested activity objectives are:

To improve demand for and the availability of quality MNCH services

1. To increase the use of MNCH services, targeting hard-to-reach populations

2. To strengthen community systems and linkages for integrated MNCH services

3. To improve Ministry of Health and Child Care (MOHCC) capacity for MNCH policy implementation.

The key activities to be implemented may include but not limited to:

• Develop HCW capacity to deliver quality, integrated MNCH services at facilities

• Scale up holistic HCW performance improvement system

• Strengthen facility and HCW capacity in maternal health, emergency newborn care and child health

• Strengthen health facility capacity to deliver adolescent- and youth (AYP)-friendly services

• Strengthened VHW capacity for community MNCH

• Strengthen integrated MNCH coordination platform at the national MOHCC and the provincial level.

• Collaborate with MOHCC and other stakeholders to apply MNCH best practices to policies.

5. Special eligibility requirements

Organizations that wish to express their interest should be:

a). Registered local, regional, or international non-governmental organizations and entities, as individuals or consortium.

b). Type of organization: Non-governmental, Private Sector entity, Public Voluntary, Civil society, local trusts, faith based, etc.

c). Have technical expertise and experience in the design, implementation, and management of MNCH service delivery activities. Organizations that currently have ongoing MNCH activities should state their country and geographic location, funding agency, total budget size and program duration, and the nature of the activities being implemented.

d). Demonstrate knowledge of the health systems in Zimbabwe and in other comparable contexts.

e). Demonstrate sound financial management including evidence of the ability to manage complex grants or contracts over $3million.

1.2. Family Planning Background

Zimbabwe’s modern contraceptive prevalence rate is one of the highest in sub-Saharan Africa, with 69 percent (Family Planning Estimation Tool 2020) of currently married women reporting current use of a modern family planning method. Underlying health system challenges undermine further progress in ensuring voluntary, informed choices and access to a broad range of contraceptives by all who need FP services.

Seventy-three percent of contraceptive users in Zimbabwe access FP services through the public sector, and the preferred FP methods are highly skewed towards short-term methods, in particular oral contraceptives, with 41 percent of women reporting use of this method (ZDHS 2015/2016). The unmet need for family planning is at 10% which is high. The Zimbabwe Ministry of Health and Child Care is insufficiently capacitated to promote and provide long-term reversible FP methods resulting in a skewed national method mix. Other factors, such as FP commodity stock-ruptures, limited time for provider-client interactions, heavy workload, and provider biases also contribute to the skewed method mix. Many primary health care facilities lack providers with the skills to offer integrated FP services, especially in remote, underserved areas.

This assistance activity will therefore strengthen the delivery of FP services in Zimbabwe by ensuring a wider choice of FP methods including LAPM in urban, peri-urban and rural communities. This assistance activity will contribute to the reduction of maternal mortality and morbidity through increased access to comprehensive, voluntary family planning services to poor and underserved populations in Zimbabwe.

The suggested activity objectives are:

1. To increase awareness of comprehensive, voluntary FP methods particularly LAPM methods among underserved women and men aged between 15 -49 years by 2028.

2. To provide comprehensive voluntary and free FP services to women and men from poor and underserved communities through mobile clinical outreach nationwide and the private sector by 2028.

The key activities to be implemented may include:

• Extension of geographic coverage of FP through mobile outreach teams to bring free services to the remotest areas of Zimbabwe.

• Expand the current FP method mix offered to clients nationwide, with particular focus on improving access to LAPM.

• Improve the quality and range of FP services offered in the private sector through innovative and sustainable methods

• Improve the quality of service and client provider interactions to reduce discontinuation rates and improve client satisfaction.

• Dispel myths and misconceptions around FP through social and behavior change communication (SBCC) activities such as community sensitization, group education and mass media through various channels.

V. Special eligibility requirements

Organizations that wish to express their interest should be:

a). Registered local, regional, or international organization and entities, either as individuals or consortium.

b). Type of organization: Non-governmental, Private Sector entity, Public Voluntary, Civil society, local trusts, faith based, etc.

c). Have technical expertise and experience in the design, implementation, and management of MNCH service delivery activities. Organizations that currently have ongoing MNCH activities should state their country and geographic location, funding agency, total budget and program duration, and the nature of the activities being implemented.

d). Demonstrate knowledge of the health systems in Zimbabwe and in other comparable contexts.

e). Demonstrate sound financial management including evidence of the ability to manage complex grants or contracts over $3million.

ATTACHMENT 2 – RFI SUBMISSION INSTRUCTIONS AND RESPONSE TEMPLATE

Interested and qualified respondents are invited to answer the questions and provide feedback on items listed below.

Interested parties are strongly encouraged to submit a response to this inquiry. All submissions must be via email, and should be in the following format:

Email Subject Line: USAID/Zimbabwe MNCH/FP Health Activity/Activities RFI – Organization Name

File Attachment: USAID/Zimbabwe MNCH/FP Health Activity/Activities RFI – Organization Name

All responses to this RFI must be emailed to the email addresses stated on the Cover page of the RFI Request Letter, by no later than the date and time listed on the cover letter. Submitted documents and correspondence must be in the English language and MS/word format (software versions 2003 or newer). The contents must be on A4 size paper, single spaced, with 12-point font, Times New Roman with one-inch margins on all sides.

Responses should be no more than five (5) pages in total, with up to one page summarizing your organization’s capacity to support the USAID/Zimbabwe objectives to provide service delivery and technical assistance to improve MNCH and FP/RH services. The remaining pages (up to four) should answer technical and service delivery modality questions, and provide any other innovations, insights or experience in design and implementation of MNCH, and/or FP services to ensure client-centered, high-impact, high-quality services are available to Zimbabweans and improve health outcomes. Please include specific MNCH/FP experience and any other contextual insights based on geography (e.g. urban vs. peri-urban vs. rural, or targeted v nationwide, or integrated vs. vertical service delivery models). Partnerships among organizations in the submission of future proposals, including by a consortium of partners with diverse but complementary expertise, will be strongly encouraged.

Phone calls or hard copy delivery of information will not be accepted.

Any proprietary information MUST BE CLEARLY MARKED. In the absence of clear marking, USAID/Zimbabwe will assume that the respondent does NOT object to the release of its submission to other United States Government offices or programs

A. Organizational Capacity Questions

(Please limit responses to 1 page)

1. Provide a summary of organizational core technical and structural capabilities with examples of past experience and achievement including populations served, geographic locations, models of service delivery, financial management, organizational capacity, staffing, management information system (MIS) for data, any health commodities supply chain management and commodity security experience, and experience with donor funding and familiarity with USG compliance standards.

2. Describe your organization's technical and institutional capacity, previous experience, and results with implementing MNCH, and/or FP activities at the health facility and community levels to promote client-centered, high quality health services.

● Please describe how your organization has worked to strengthen access to and the provision and experience of high-quality MNCH, and/or FP services in Zimbabwe and/or other countries in sub-Saharan Africa. Highlight key lessons learnt in the delivery of MNCH/ FP services and in provision of technical support to relevant government partners.

● Describe how your organization has strengthened health systems that support the delivery of high quality MNCH and/or FP/RH services.

● Please describe how your organization has increased generation and use of data, evidence and learning to optimize the achievement of key MNCH/FP/RH outcomes and inform policies and programs.

Technical Approaches and Modalities for Service Delivery Questions (MNCH, FP)

(Please limit responses to 4 pages)

1. For each technical area, (MNCH and FP/) answer the following three questions based on your organization’s past and present experience. Include specific details about provincial or other geographic differences, if applicable.

● What is working well in MNCH and FP service delivery?

● What challenges exist that require context specific approaches? (e.g. challenges due to geography (provincial, district), population type, service delivery approaches, gender, religion, cultural norms, etc). How would you address these challenges?

● What resources can be leveraged to improve and sustain MNCH and/or FP services?

Describe any pivotal innovations in service delivery of MNCH and/or FP, including high impact practices and new/underused technologies, that have improved your organization’s ability to improve health outcomes and should be considered for further expansion and/or uptake.

2. What challenges are associated with integration or verticalization of MNCH and/or FP services? What policy barriers, if any, need to be addressed? How would you address the challenges and policy barriers?

3. What interventions are currently underway to engage with the private sector in MNCH and/or FP and what other opportunities exist that would strengthen continued private sector engagement and collaboration? How would you strengthen private sector engagement with MNCH and FP service delivery?

4. What consideration must be made to ensure optimal services when shifting from an integrated service delivery (ISD) model to a more vertical service delivery (VSD) for MNCH and FP, and how has your organization adapted to both service delivery models when implementing health programs in Zimbabwe?

5. What efficiencies are in place and what efficiencies are needed to implement to guarantee sustainable and replicable programs that GoZ can sustain and scale up in the future? How would you implement these efficiencies as part of a USAID supported FP/MNCH program?

6. What specific cultural and gender norms need to be considered in order to ensure successful implementation of MNCH and FP/RH services in the country? How would you address these cultural and gender norms?

● Specific to family decision-making norms regarding MNCH and/or FP, what social, cultural and gender norms must be addressed alongside improving access to health information and services?

ATTACHMENT 3

Request for Information or Solicitation for Planning Purposes (Oct 1997)

(a) USAID/Zimbabwe does not intend to award an assistance award or a contract on the basis of this solicitation or to otherwise pay for the information solicited except as an allowable cost under other contracts as provided in subsection 31.205-18, Bid and proposal costs, of the Federal Acquisition Regulation.

(b) Although "proposal" and "offeror" are used in this Request for Information, your response will be treated as information only. It shall not be considered as a proposal or an application.

(c) This solicitation is issued for the purpose of designing an activity with the preliminary title of “USAID MNCH and FP Health Activity.”

[END OF REQUEST FOR INFORMATION]